FDA Adverse Event
Injury
Summary report: N
ALLEGRETTO WAVE EYE-Q
MDR report key: 3952863
·
Received July 14, 2014
Report
- Report Number
- 3003288808-2014-01099
- Event Type
- Injury
- Date Received
- July 14, 2014
- Date of Event
- June 16, 2014
- Report Date
- June 16, 2014
- Manufacturer
- WAVELIGHT AG
- Product Code
- LZS
- PMA / PMN Number
- P030008
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVALUATION SUMMARY: INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE. (B)(4).
Description of Event or Problem · 1
A TECHNICIAN REPORTED THAT A PATIENT EXPERIENCED A GRITTY FEELING IN HER EYES AS A RESULT OF DECREASED TEAR PRODUCTION CAUSING DRY EYES, 4 DAYS FOLLOWING BILATERAL LASIK SURGERY. IN A FOLLOW UP THE TECHNICIAN REPORTED THAT THE PATIENT WAS TREATED WITH MEDICATIONS AND THE EVENT IS IMPROVING. THE PATIENT WILL RETURN FOR FOLLOW-UP CARE IN A MONTH. NO FURTHER INFORMATION IS EXPECTED. THERE ARE TWO MEDICAL DEVICE REPORTS ASSOCIATED WITH THIS EVENT. THIS REPORT IS FOR THE RIGHT EYE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 410112 | ALLEGRETTO WAVE EYE-Q | OPHTHALMIC EXCIMER LASER SYSTEM | LZS | WAVELIGHT AG | 8065990601 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 35 YR | Required Intervention | INTRALASE |